Training Future Doctors on Climate-Sensitive Infections: One Health Practices in Southeastern Europe
Abstract
Background: Climate change increasingly influences infectious disease risks across Europe. Rising temperatures and expanding mosquito vectors facilitate the spread of arboviral diseases such as dengue, chikungunya and West Nile fever, including in regions where these infections were previously unknown. Recent European outbreaks show that such diseases may appear rapidly once ecological conditions become favourable. Preparing future physicians to recognize and respond to climate-sensitive infections is therefore an emerging public health priority still insufficiently reflected in medical education.
Educational approach: A climate–health module was integrated into the infectious epidemiology clinical placement of final-year medical students at the Medical University of Varna, Bulgaria (2025–2026). Training combines classic epidemiological analysis, climate data interpretation and vector-borne risk assessment within a novel One Health framework. Students analyse regional surveillance data and explore links between climate variability, vector distribution and infectious risks.
Results: Regional surveillance data indicate increasing climate-related infectious risks. In Bulgaria, West Nile fever remains the only arboviral infection with documented local transmission, with sporadic cases since 2018 and an increase to 31 cases in 2024. Dengue and chikungunya infections remain mainly imported but reflect expanding global transmission trends. The invasive mosquito Aedes albopictus, established nationally since 2011, creates conditions for potential local transmission. Climate observations show a rise in mean annual temperature (∼0.8 °C) and more frequent heatwaves favouring vector expansion.
Conclusions: Medical education must evolve alongside emerging climate-driven infectious risks. This pioneering training initiative offers a transferable model for strengthening future physicians’ competencies and supporting climate-resilient health systems in Europe.
Key messages: • Climate-sensitive infections are emerging in new European regions; integrating One Health and climate science into medical education is essential for future health workforce preparedness.
• Innovative climate-health training linking public health surveillance, epidemiology and education can strengthen EU health security and early response to emerging arboviral threats.
Related
- Knowledge, attitudes, and practices regarding cystic echinococcosis among healthcare students and intern doctors in the west bank: a cross-sectional study
- Training future doctors in youth health: an innovative public health approach
- Mycobacterium leprae infection, Hansen’s disease, and helminth infections: A cross-sectional study in southeastern Brazil
- Infection prevention training and adherence to infection control practices in childcare and early childhood education facilities during COVID-19: a nationwide cross-sectional study in Japan
- A global survey of diagnostic practices in prosthetic joint infections
BibTeX
@article{ivanova2026training,
title = {{Training Future Doctors on Climate-Sensitive Infections: One Health Practices in Southeastern Europe}},
author = {E Ivanova and M Papancheva and M Boneva and D Vankova},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1151},
url = {https://doi.org/10.1093/eurpub/ckag169.1151},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Training Future Doctors on Climate-Sensitive Infections: One Health Practices in Southeastern Europe
AU - E Ivanova
AU - M Papancheva
AU - M Boneva
AU - D Vankova
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1151
UR - https://doi.org/10.1093/eurpub/ckag169.1151
AB - Background: Climate change increasingly influences infectious disease risks across Europe. Rising temperatures and expanding mosquito vectors facilitate the spread of arboviral diseases such as dengue, chikungunya and West Nile fever, including in regions where these infections were previously unknown. Recent European outbreaks show that such diseases may appear rapidly once ecological conditions become favourable. Preparing future physicians to recognize and respond to climate-sensitive infections is therefore an emerging public health priority still insufficiently reflected in medical education. Educational approach: A climate–health module was integrated into the infectious epidemiology clinical placement of final-year medical students at the Medical University of Varna, Bulgaria (2025–2026). Training combines classic epidemiological analysis, climate data interpretation and vector-borne risk assessment within a novel One Health framework. Students analyse regional surveillance data and explore links between climate variability, vector distribution and infectious risks. Results: Regional surveillance data indicate increasing climate-related infectious risks. In Bulgaria, West Nile fever remains the only arboviral infection with documented local transmission, with sporadic cases since 2018 and an increase to 31 cases in 2024. Dengue and chikungunya infections remain mainly imported but reflect expanding global transmission trends. The invasive mosquito Aedes albopictus, established nationally since 2011, creates conditions for potential local transmission. Climate observations show a rise in mean annual temperature (∼0.8 °C) and more frequent heatwaves favouring vector expansion. Conclusions: Medical education must evolve alongside emerging climate-driven infectious risks. This pioneering training initiative offers a transferable model for strengthening future physicians’ competencies and supporting climate-resilient health systems in Europe. Key messages: • Climate-sensitive infections are emerging in new European regions; integrating One Health and climate science into medical education is essential for future health workforce preparedness. • Innovative climate-health training linking public health surveillance, epidemiology and education can strengthen EU health security and early response to emerging arboviral threats.
SN - 1101-1262
SN - 1464-360X
ER -